| NPI | 1023070968 |
|---|---|
| Former Name | MARTHA DAWSON FAIRBANKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: DC 210012313) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2012-02341) |
| 208000000X Pediatrics (Licence: MA 224904) | |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: MA 224904) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2023-10-10 |